Anterograde bile duct drainage for intractable bile leakage after hepatectomy in a patient with previous pancreatoduodenectomy: A case report
| Autor: | Yasuhiro Tani, Tsutomu Haneda, Chihiro Ishizuka, Yo Kamiizumi, Takeshi Tsuji, Sayuri Kashiwakura, Koji Ito, Tadashi Yoshida, Hironori Kasai, Ryohei Murata |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Bile duct drainage
medicine.medical_specialty Tube forming medicine.medical_treatment 030230 surgery Bile leakage Partial hepatectomy digestive system Article 03 medical and health sciences 0302 clinical medicine medicine Hepatectomy Intrahepatic Cholangiocarcinoma Choledochojejunostomy Pancreatoduodenectomy Bile duct business.industry Anterograde drainage Surgery Catheter medicine.anatomical_structure 030220 oncology & carcinogenesis business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2019.01.017 |
| Popis: | Highlights • Endoscopic retrograde drainage is effective for managing bile leakage. • Bile drainage after pancreatoduodenectomy with choledochojejunostomy is difficult. • Post-hepatectomy bile leakage in a patient with prior pancreatoduodenectomy. • Selective anterograde bile duct drainage was successful in treating the condition. Introduction Endoscopic retrograde drainage is effective for managing bile leakage, which is relatively common after hepatectomy without bile duct reconstruction. However, the procedure is difficult to perform after pancreatoduodenectomy with choledochojejunostomy. We present a case of anterograde bile duct drainage for intractable bile leakage after hepatectomy in a patient with previous pancreatoduodenectomy. Presentation of case An 80-year-old woman with a history of pancreatoduodenectomy for distal biliary cancer and adjuvant chemotherapy presented with bile leakage. Six years after the pancreatoduodenectomy, she underwent partial hepatectomy for suspected metastasis or intrahepatic cholangiocarcinoma. On the 9th postoperative day, bile leaked from her drainage tube forming an abscess cavity; this continued until the 28th postoperative day. We attempted selective anterograde drainage from the cut surface of the liver under fluoroscopic guidance using a guidewire and Cobra-type catheter. We selectively cannulated the entrance hole of the bile duct. Twenty days after the drainage, the abscess cavity disappeared. After 41 days, the tube was removed, and the patient was discharged. We suggest this procedure as a possible treatment option for difficult bile leakage cases. Discussion A case of intractable bile leakage after hepatectomy in a patient with a previous history of pancreatoduodenectomy is difficult to manage, and usually needs surgical intervention. The effect of selective cannulation of the entrance hole of the bile duct has not been studied. Conclusion Selective anterograde bile duct drainage for intractable bile leakage after hepatectomy in a patient with a previous history of pancreatoduodenectomy successfully resolved bile duct leakage in our patient. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|